Premenstrual dysphoric disorder

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). A woman with PMDD has severe depression and anxiety symptoms, irritability, and tension before menstruation. It disrupts normal daily functioning and requires medical treatment.

What's Inside?

What is the difference between PMS and PMDD?

PMS refers to a wide range of symptoms that occur about 6 to 11 days before menstrual cycle begins. In most cases, these symptoms stop shortly after the cycle begins. Some of the key differences between PMS and PMDD are as following –


  • Depression
    During PMS, one can find themselves feeling low for no apparent reason. However, during PMDD, there is an extreme sadness that results into hopelessness. This interferes with one’s daily tasks and are extremely difficult to cope with.

  • Anxiety
    A woman having PMS might feel anxious but with PMDD, the feelings are intense and often debilitating. Some women with PMDD describe feeling constantly on edge before their menstrual cycle.

  • Mood swings
    PMS can cause a woman to get moody. PMDD is more likely to make a woman feel like she is not in control of her life. She might get very angry and things that don’t normally bother her might cause irritability and tension.

  • Feelings about life
    With PMS, one might feel a little detached from the usual routine. PMDD may cause indifference towards one’s job, hobbies, friends, family or anything that otherwise would cheer one up.

What are the symptoms of PMDD?

The criteria to diagnose to PMDD included details such as the timing of the symptoms, severity, type and whether the symptoms are caused by another pre-existing condition, medication or substance. Some of the symptoms monitored for diagnosis are –

  • Exaggerated changes in mood or emotion that can occur suddenly
  • Irritability, anger or increased relationship conflicts
  • Depressed mood, feelings of hopelessness or being overly critical of yourself
  • Anxiety, tension or increased feelings of nervous excitement
  • Decreased interest in usual activities
  • Noticeable difficulty while trying to concentrate
  • Severe fatigue or lack of energy
  • Drastic changes in appetite, including overeating or specific food cravings
  • Changes in sleep patterns, including excessive sleeping or the inability to sleep
  • Feeling overwhelmed or out of control
  • Presence of physical symptoms that are also found with PMS (breast tenderness, bloating,
    swelling, etc.)

What are the treatments available?

Medication –

Medications that affect ovulation and the central nervous system are often administered to treat
PMDD. Antidepressants and oral contraceptives are given based on the severity of the condition.

Alternative remedies –

  • Cognitive therapy has been shown to help ease the symptoms for PMS and PMDD.
  • Other therapies like guided imagery, photic simulation, acupuncture might help as advised
    by the concerned healthcare provider.
  • Other coping strategies to adopt include being easy on oneself on the days before menstrual
    cycle, talking to a trusted individual for emotional support, finding activities that relive tension like going for a walk, reading etc.